Stressful life events, psychiatric comorbidities and serum neuromediator levels in patients with chronic spontaneous urticaria treated with omalizumab.

INTRODUCTION: Many chronic spontaneous urticaria (CSU) patients have highly stressful life events and exhibit psychiatric comorbidities. Emotional stress can cause or exacerbate urticaria symptoms by causing mast cell degranulation via neuromediators. OBJECTIVES: To investigate the frequency of stressful life events and compare psychiatric comorbidities and serum neuromediator levels in patients with CSU who responded to omalizumab with healthy controls. METHODS: In this cross-sectional study, we included 42 patients with CSU who received at least 6 months of omalizumab treatment and a control group of 42 healthy controls. Stressful life events were evaluated with the Life Events Checklist for DSM-5 (LEC-5). The Depression Anxiety Stress Scale-42 (DASS-42) was used to evaluate depression, anxiety and stress levels. Serum nerve growth factor (NGF), calcitonin gene-related peptide (CGRP) and substance P (SP) levels were measured using the enzyme-linked immunosorbent assay (ELISA) technique. RESULTS: Twenty-six (62%) patients reported at least one stressful life event a median of 3.5 months before the onset of CSU. There were no significant differences in all three variables in the DASS subscales between the patient and control groups. Serum NGF levels were found to be significantly lower in patients with CSU (p <0.001), whereas CGRP levels were found to be significantly higher (p <0.001). There was no significant difference for SP. CONCLUSIONS: The psychological status of patients with CSU who benefited from omalizumab was similar to that of healthy controls. Omalizumab may affect stress-related neuromediator levels.

Behavioral and hormonal effects of prenatal and maternal separation stresses in postpartum rats.

The aim of this study was to evaluate the hormone and anxiety levels of rat dams who were exposed to prenatal and maternal separation stress paradigms. Sprague-Dawley rat dams were divided into Prenatal Stress (PS), Maternal Separation (MS), Prenatal Stress and Maternal Separation (PS+MS), and Control (C) groups. All animals were subjected to the open field test on the 21st postnatal day. Same-day blood samples were obtained from the tail vein in order to examine corticotrophin-releasing hormone (CRH), estradiol, oxytocin, epinephrine, norepinephrine, prolactin, progesterone, brain-derived neurotrophic factor (BDNF), endorphin, and vasopressin levels of animals via enzyme-linked immunosorbent assay (ELISA). Oxytocin levels were the highest in the control group and the lowest in the MS group. CRH levels in the MS group were significantly higher than in the PS group (p < .05). Intriguingly, the BDNF level was the lowest in the control and highest in the MS group. While there was a strong correlation in the CRH, vasopressin, BDNF levels in the control group, various relations were observed in the stress groups. Stressed animals exhibited several behavioral anomalies including decreased fear responses such as freezing, enhanced duration, and increased number of entries into the central zone of the open field test apparatus. PS dams exhibited reductions in estradiol and norepinephrine levels relative to control or MS dams.

Evaluation of the risk factors for acute occupational hand injuries.

OBJECTIVES: To evaluate the effect of demographic and occupational factors on the severity of the acute occupational hand injuries. METHODS: Patients with acute hand injuries presenting to the emergency department of the Ege university hospital between 01.08.2008 and 27.02.2009 were included. A questionnaire investigating demographic and occupational factors of the patients and their injuries was filled out for each patient. Modified Hand Injury Severity Score (MHISS) was used to assess the severity of the injury. RESULTS: A total of 144 subjects were included. Forty-three patients had occupational hand injuries. Age at injury, occupation, and main earning status did not alter the MHISS score significantly. Also, the mechanism of injury, occupational experience, timing of the injury, glove use, safety training did not have a significant effect on the injury severity. The injury pattern was found to have a statistically significant effect on the MHISS score. CONCLUSION: The potentially modifiable factors such as the working conditions, safety training and use of gloves are important in the etiology of occupational acute hand injury. Most probably, in this study the size of the sample was not large enough to be able to demonstrate any relation between these and the injury severity. However, attempts to modify these factors by various strategies may reduce the incidence of acute hand injury at work. Precautions and widespread educational programs can prevent occupational acute hand injury.